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The experience of nutritional care according to patients with head and neck cancer involved with a combined dietitian, specialist nurse and speech pathologist clinic in a regional Australia: a qualitative longitudinal study

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Abstract

Purpose

Malnutrition is a co-morbidity of head and neck cancer (HNC) that has negative consequences for patients. Evidence-based guidelines (EBGs) provide recommendations to prevent and manage malnutrition. A clinic that combines the services of a dietitian, specialist oncology nurse and speech pathologist may promote the implementation of nutritional EBGs in regional Australia. This study aimed to explore the nutritional care experience that patients with HNC had in this setting.

Methods

A qualitative longitudinal study collected data via semi-structured interviews with HNC patients who were treated in one regional cancer care network in Australia. Interviews were conducted at key points in their HNC journey from diagnosis to 4 months post-radiotherapy. Data was analysed using a grounded theory approach.

Results

Ten participants completed a total of thirty-six interviews. The findings were grouped into four categories: “preparing for nutritional challenges”, “multidisciplinary care directed by patient needs”, “the battle to eat”, and “incongruence between patient values and nutritional priorities”.

Conclusion

These findings highlight the nutritional burden associated with HNC and barriers to patients accepting nutritional support from healthcare professionals. Information provided by doctors and nurses prior to treatment may help patients prepare for the nutritional challenges ahead and accept support from dietitians. Furthermore, clinics that promote continuity through treatment and allow dietitians to lead aspects of nutritional care, in collaboration with nurses, speech pathologists and doctors, may also enhance the nutritional care experience. More qualitative research within HNC teams would provide further insight on enhancing the implementation of nutritional EBGs to improve outcomes for these patients.

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Funding

This research has been conducted with the support of the Australian Government Research Training Program Scholarship and the Illawarra Cancer Care Radiation Oncologist Staff-Specialist Trust Fund.

Author information

Authors and Affiliations

  1. Department of Nutrition and Dietetics, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia

    Emily Hazzard & Jennifer Haughton

  2. School of Medicine, University of Wollongong, Wollongong, NSW, 2522, Australia

    Emily Hazzard & Karen Walton

  3. Research Central, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia

    Janaye Fish

  4. Illawarra and Shoalhaven Cancer Care Centres, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia

    Vhari Dickson

  5. Department of Speech Pathology, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia

    Jessica Boehm

  6. Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW, 2500, Australia

    Marianna Milosavljevic & Bruce Ashford

Authors
  1. Emily Hazzard
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  2. Jennifer Haughton
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  6. Jessica Boehm
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  7. Karen Walton
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  8. Bruce Ashford
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Contributions

JH: conceptualization, project administration, recruitment, formal analysis, writing—review and editing. EH: methodology, formal analysis, writing—original draft, review and editing. JF: investigation, data curation, project administration, formal analysis, writing—review and editing. MM: supervision, methodology, formal analysis, writing—review and editing. VD: conceptualization, formal analysis, recruitment, writing—review and editing. JB: conceptualization, formal analysis, recruitment, writing—review and editing. KW: methodology, supervision, writing—review and editing. BA: supervision, recruitment, writing—review and editing.

Corresponding author

Correspondence to Emily Hazzard.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

This study was approved by the Human Research Ethics Committee at the University of Wollongong (HE14/470).

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Consent to participate and publish data was obtained from all participants.

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Hazzard, E., Haughton, J., Fish, J. et al. The experience of nutritional care according to patients with head and neck cancer involved with a combined dietitian, specialist nurse and speech pathologist clinic in a regional Australia: a qualitative longitudinal study. Support Care Cancer 29, 4329–4337 (2021). https://doi.org/10.1007/s00520-020-05917-9

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  • DOI: https://doi.org/10.1007/s00520-020-05917-9

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